The scope of this thesis is to shed more light, from a number of perspectives, on surgically
assisted rapid maxillary expansion (SARME). The primary questions this thesis
set out to answer were; ‘is there a difference in stability between bone-borne and
tooth-borne distraction?’ and ‘can a relationship be found between segmental maxillary
tipping, relapse, and the mode of distraction?’ Secondary questions were; ‘what is
the influence of surgically assisted rapid maxillary expansion on the nasal airway and
the nasalance of speech?’ and ‘what is the effect of surgically assisted rapid maxillary
expansion on the upper facial appearance?’ The thesis is divided into five Parts.
Part I consists of the general introduction, a review of the literature on SARME
(Chapter 1). No consensus could be found regarding the surgical technique, the type of
distractor used (tooth-borne or bone-borne), the existence, cause and amount of relapse,
and whether or not overcorrection is necessary. Furthermore, relapse is widely
recognized yet poorly explicated. A wide variety of techniques and methods to correct
transverse maxillary hypoplasia is currently used without underlying scientific basis.